Frontiers of Health Services Management - Spring 2014 - (Page 5)

Equity Work at Baylor As Baylor's quality structure was taking shape in the late 1990s, a foundation was also being laid for another important strategy: equity of care. 1996-2006: Community Focus and Volunteerism HealthTexas Provider Network (HTPN), Baylor's employed physician organization, was developing strategies intentionally focused on care for underserved populations, both locally and abroad. Like many large, urban, nonprofit hospitals in the United States, Baylor was already providing millions of dollars' worth of charitable care, mostly through its hospitals and emergency departments. However, its strong Christian roots as a ministry of healing led organizational leaders to contemplate more systematic ways to fulfill its mission. Baylor's earliest forays into health equity focused largely on the community service component of its mission statement, to serve all people through exemplary healthcare, education, research, and community service. In 1996, HTPN created a community service initiative called Volunteers-inMedicine (VIM) to encourage physician and staff volunteerism and build a culture of service within HTPN. While the VIM program was forming, a similar movement was starting in North Texas. Numerous churches, ministries, and other faithbased organizations were responding to the growing crisis of uninsured individuals in the community who lacked access to medical care. In the Dallas-Fort Worth metroplex, approximately 24 percent of the area's population-almost 1.5 million residents-do not have health insurance (US Census Bureau 2011, 2013). Texas is known to have the largest percentage of uninsured patients in the United States; some reports place this figure as high as 28 percent of the state's population (Mendes 2013). Faith-based organizations' response to the uninsured crisis was to build charitable health clinics, most of which were dependent on volunteer physicians, nurses, and other providers to serve patients. Through J oe l T. A ll iso n, F A CHE; C l iff Ful l e r t on; a nd Ada m C ha b ir a * 5 F E A T U R E group of leaders needed an in-depth understanding of quality improvement methods, tools, and language. To that end, from 2001 through 2003, Baylor sent 40 of its quality leaders to Intermountain Healthcare's (2013) mini-Advanced Training Program course, led by Brent C. James, MD, executive director of the Institute for Health Care Delivery Research at Intermountain. James shared his educational templates with Baylor leaders, who adapted them, with James's approval, to feature Baylor-based examples relevant to its employees. Over the past decade, more than 1,500 Baylor physician, nursing, and administrative leaders have received healthcare quality improvement training through the resulting "ABC Baylor" course, now known as STEEEP Academy. Baylor leaders understood that, in addition to the STEEEP Academy training and the incentives earned from linking leader compensation to clinical quality performance, the organization needed structures that support its commitment to quality improvement. Baylor recognized that the best quality-focused health systems regularly convene clinical, financial, and operational leaders to address approaches to highquality healthcare delivery (Berry and Seltman 2008). Over time, Baylor has crafted an approach that brings these leaders to a common table through the STEEEP Governance Council (SGC), which promotes improvement efforts that seek to achieve synergy across all domains of STEEEP care. The SGC structure has enabled Baylor to apply clinical, financial, and operational frames of reference to organizational decisions about healthcare initiatives.

Table of Contents for the Digital Edition of Frontiers of Health Services Management - Spring 2014

Frontiers of Health Services Management - Spring 2014
Contents
Editorial
Baylor Health Care System’s Journey to Provide Equitable Care
In Pursuit of High-Value Healthcare: The Case for Improving Quality and Acheiving Equity in a Time of Healthcare Transformation
Ending Healthcare Disparities: An Urgent Priority and a Growing Possibility
Expanding the Evidence Base for Health Equity
A Historical Perspective on Disparities as Context for Our Work Ahead

Frontiers of Health Services Management - Spring 2014